在定制全踝关节置换术中，用于植入物定位的患者专用器械的准确性。

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2024-07-26 DOI:10.1002/jeo2.12026

Antonio Mazzotti, Simone Ottavio Zielli, Alberto Arceri, Elena Artioli, Laura Langone, Federico Sgubbi, Giuseppe Geraci, Cesare Faldini

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引用次数: 0

摘要

目的：这项回顾性放射学分析旨在评估与术前规划相比，接受定制全踝关节置换术（TAA）并使用患者特异性器械（PSI）的踝关节炎患者植入物定位的准确性：回顾性评估了2018年1月至2023年3月期间接受定制全踝关节置换术（TAA）的患者，重点关注胫骨前表面（TAS）角度、胫骨外侧表面（TLS）角度和胫腓骨比（TTR）。此外，还记录了从术前计算机断层扫描（CT）到手术的时间、相关手术和并发症的数据：结果：未进行任何相关手术，仅记录了一起术中并发症，即先天性外侧踝骨骨折。在冠状面上，即使术前存在明显畸形或骨质缺损的病例，使用 PSI 定制 TAA 也能始终实现假体组件的精确定位。然而，在矢状面上观察到与计划值有明显的统计学偏差（p = 0.007）。从术前 CT 扫描到手术的时间与术后 TAS 角度从计划值到实际值的偏差之间存在明显的相关性（p 结论：术后 TAS 角度从计划值到实际值的偏差之间存在明显的相关性（p 结论：术后 TAS 角度从计划值到实际值的偏差之间存在明显的相关性（p）：本研究强调了 PSI 系统在按照术前计划实现冠状面精确定位方面的功效。与此相反，矢状面定位并没有表现出同样的准确性，这体现在计划值与术后 TLS 值之间存在显著的统计学差异。尽管如此，根据现有文献，所有测量值仍在推荐范围内：证据等级：IV 级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Accuracy of patient-specific instrumentation for implant positioning in custom-made total ankle arthroplasty

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Accuracy of patient-specific instrumentation for implant positioning in custom-made total ankle arthroplasty

Purpose

This retrospective radiological analysis aimed to assess the accuracy of implant positioning in patients with ankle arthritis undergoing custom-made total ankle arthroplasty (TAA) with patient-specific instrumentation (PSI) compared with preoperative planning.

Methods

Patients who underwent custom-made TAA with PSI from January 2018 to March 2023 were retrospectively evaluated, focusing on the tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle and tibiotalar ratio (TTR). Additionally, data regarding the time from the preoperative computed tomography (CT) scan to surgery, associated procedures and complications were recorded.

Results

No associated procedures were performed, and only one intraoperative complication, an iatrogenic lateral malleolar fracture, was recorded. In the coronal plane, custom-made TAA with PSI consistently achieved precise positioning of prosthetic components, even in cases with significant preoperative deformities or bone deficits. However, a statistically significant deviation from the planned values was observed in the sagittal plane (p = 0.007). A notable correlation was identified between the time elapsed from the preoperative CT scan to surgery and the deviation from the planned to the actual postoperative TAS angle (p < 0.001).

Conclusion

This study underscores the efficacy of PSI systems in achieving precise positioning in the coronal plane, in accordance with preoperative planning. In contrast, sagittal plane positioning did not demonstrate the same level of accuracy, as evidenced by a statistically significant difference between the planned and postoperative TLS values. Nevertheless, all measurements remained within the recommended range according to the existing literature.